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“Changing lives through education, training, and skill development.”
Sterile Processing
Technician
Application
P.O Box 2000
709 S. Old Missouri Road
Springdale, AR 72765
Phone: 479-751-8824 Ext. 116
Fax: 479-750-7272
www.nwti.edu
Revised 9/25/2020
Jessica Diaz Melara 479-751-8824 ext. 116
Allied Health Office Assistant
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STERILE PROCESSING TECHNICIAN PROGRAM PROGRAM HISTORY
Sterile Processing Technicians (SPT) play a critical role in keeping patients healthy by ensuring medical
instrumentation and equipment is sterile. Their work helps patients avoid infections while receiving treatment.
They also maintain the functionality and inventory of healthcare and surgical equipment.
The SPT can work in a sterile processing department and central service department in a variety of healthcare
facilities, including hospitals, dental or eye care practices, plastic surgery offices, surgery centers and
laboratories. You will contribute to a team of sterile processing technicians who are all working together to
maintain sterilization and storage.
PART-TIME SCHEDULE
The program is offered every semester. Theory classes are held Tuesday, Wednesday, and Thursday from 5:30
pm to 8:30 pm, for 14 weeks
EMPLOYMENT
Full-time employment is possible given the program is offered part-time in the evening.
FINANCIAL AID
Financial aid is not available.
SELECTION PROCESS FOR THE STERILE PROCESSING TECHNICIAN
Students should submit an application and supply one reference.
ADVANCED PLACEMENT
This is an good introductory program for the Surgical Technology Program.
BACKGROUND CHECK AND DRUG SCREEN
Background checks and a drug screen are required.
Questions about this program can be answered Monday through Friday 7:30 am - 4:00 pm by calling 479-751-
8824 ext. 116.
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NWTI Adult Education Scholarship Information
Northwest Technical Institute Adult Education Center has partnered with the Northwest Technical Institute
Allied Health Department to offer scholarships for students who will co-enroll in the NWTI Adult Education
Center and NWTI Sterile Processing Technician (SPT) program.
What will the scholarship cover?
Full NWTI Tuition in the amount of $420.00
NWTI Application Fee $10.00*
NWTI Accuplacer Exam (One Free Testing) $5.00*
*Applicants must contact NWTI Adult Education staff before the Application and Accuplacer testing has been
processed in order to receive the waivers for application and one time testing fee waiver.
How do I become eligible?
Students must meet the qualifications for acceptance into the NWTI Sterile Processing Technician (SPT)
program:
Students will take a Free TABE assessment at the NWTI Adult Education Center to determine skill
level. If a student has a skills deficiency determined by the Free TABE Assessment the student will be
offered the NWTI Adult Education SPT Scholarship.
Students can still have a skills deficiency even if he or she has received a college degree.
Students must meet a minimum Reading score 501 and Language score of 511
The NWTI Adult Education Director will submit all paperwork to NWTI Allied Health Department and NWTI
Business Office detailing the scholarship.
When should I apply for the scholarship?
It is best for students to contact the NWTI Adult Education Center and NWTI Allied Health Department at the
time of application for the NWTI Sterile Processing Technician (SPT) program.
*The TABE assessment test given by the NWTI Adult Education Center must be within 90 days of the first day
of the Sterile Processing Technician (SPT) program. If not within 90 days the scholarship becomes void.
NWTI Adult Education Center
610 E Emma Suites 200
Springdale, AR 71765
479 751 0181
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STERILE PROCESSING TECHNICIAN PROGRAM CHECKLIST
Thank you for inquiring about Northwest Technical Institute’s Sterile Processing Technician Program. This is
a 3-month program that begins in September and ends in December. There are no prerequisite classes. FILE COMPLETION
To be considered for this program, you must have a complete file.
Surgical Sterilization Application Packet and DD-214, if applicable ($10.00 fee) Application Fee $10.00
must be paid when application is turned in.
NEXT-GENGERATION ACCUPLACER test ($10.00) you must score a minimum 224 for Reading
Comprehension.
Due to COVID, no accuplacer is needed for enrollment for fall 2020.
High School Transcript or GED needs to be OFFICIAL transcripts. (An “Official Transcript” means it has the
embossed school seal imprint and sealed in an envelope and sent directly to the NWTI Admissions Office. You will be
responsible for any fees involved.
College Transcripts needs to be official transcripts (An “Official Transcript” means it has the embossed school
seal imprint and sealed in an envelope and sent directly to the NWTI Admissions Office. Please see cover page about
transfer credit.
Immunization Records includes Two (2) Measles & Rubella (MMR) is required, if born on or after January 1,
1957. 1 Negative TB skin test or a chest x-ray (allow three working days to complete this test). Varicella: You will need
to show proof of 2 vaccines, proof of positive titer, or a note from your physician stating that you have a history of
varicella (chicken pox). DTAP: Must be within the last 10 years and cover the entire program. 3 Hepatitis B vaccine;
first 2 are given 30 days apart, and the 3rd is given 6 months later.
If you have ever tested positive or recently test positive for TB, you must have a chest X-ray showing no active
disease before class starts.
CPR Certification-American Heart Association-BLS for Healthcare Workers within 6 weeks of beginning
class.
One Reference Work or Personal is needed.
ATTN: All paperwork must be turned in all at once. One reference and transcripts must be turned in with the application.
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Curriculum The following courses must be completed satisfactorily to receive a certificate in our Sterile
Processing Technician Program:
Course Number Course Name Clock Hours Credit Hours
SPT 1003 Intro and Role of SPS 36 2 SPT 1004 Infection Prevention 54 3 SPT 1113 Instrumentation and
Sterilization 46 2
Total Hours 126 7
Total Hours 126
Total Theory Hours-90
Total Lab Hours-36
Suggested Schedule
Semester Schedule
SPT1003 Intro and Role of SPS
SPT1004 Infection Prevention
SPT1113 Instrumentation and Sterilization
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Sterile Processing Technician Program
2020-2021 Anticipated Expenses
Semester Paid to NWTI
Tuition 420.00
Institute Fees (Admin, Student Support, Facilities,
and Tech Fees)
200.00
Program Fees (Lab and insurance) 280.00
Book (ISBN # 987-1-4951-8904-3) 125.00
Other Student Expenses not paid to NWTI
CPR (price varies) Must have within 6 weeks 85.00
Background check and Drug Screen 67.00
Other Immunizations $100
Certification Fee 135.00
Total For Semester
Program Total $1,412
Please keep in mind when making your financial plans: Travel expenses to/from school and clinical sites, child
care, and other expenses.
*The above expenses are estimates and are subject to change without notice.
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NORTHWEST TECHNICAL INSTITUTE
P.O. BOX 2000 709 S. OLD MISSOURI ROAD SPRINGDALE, AR 72765-2000
PHONE: (479) 751-8824 EXT. 116 FAX: (479) 750-7272
STERILE PROCESSING TECHNICIAN APPLICATION FOR ENROLLMENT NAME_____________________________________________________________________________________________
Last First M
MAIDEN NAME: __________________________________ E-mail Address___________________________________
ADDRESS_________________________________________________________________________________________
CITY__________________________________STATE__________ZIP______________COUNTY__________________
HOME TELEPHONE__________________________________________________D.O.B.________/________/_______
CELL PHONE _________________________________SOCIAL SECURITY #____________-________-____________
HIGH SCHOOL ATTENDED_____________________________________________________________________________
SCHOOL ADDRESS___________________________________________________________________________________
DID YOU GRADUATE? ________________________________IF SO, WHAT YEAR______________________________
IF HIGH SCHOOL EQUIVALENCY ACHIEVED, GIVE NAME OF TEST: ______________________________________
COLLEGE ATTENDED__________________________________________________________________________________
HOURS____________________________________________DEGREE___________________________________________
OTHER EDUCATIONAL EXPERIENCE___________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
___________________________________________________ ______________________________________________
APPLICANT’S SIGNATURE DATE
EMERGENCY CONTACT
___________________________________________________ _____________________________________
LAST NAME FIRST NAME M RELATIONSHIP
___________________________________________________ _____________________________________
ADDRESS CITY STATE ZIP CODE
_____________________________________________________
TELEPHONE
If your contact information changes during the
admission process, please let us know.
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STERILE PROCESSING TECHNICIAN APPLICATION FOR ENROLLMENT
BACKGROUND CHECK INFORMATION
All applicants and new students are advised and must sign acknowledgements that successful completion of the Sterile
Processing Technician program at Northwest Technical Institute does not guarantee employment at area healthcare
facilities. If you have been convicted of any crime in the last three (3) years, you will not be eligible for employment at
most area healthcare facilities. Students are advised to acknowledge all past crimes, including those that have been
sealed or expunged as these may appear on their background checks that will be done prior to employment at area
healthcare facilities.
Please answer the following questions.
Do you have prior experience in any branch of the armed forces?
YES NO
If so, please attach a copy of your DD 214.
Have you ever been convicted of a misdemeanor or felony or pled guilty or nolo contendere to any charge in any
state or jurisdiction?
YES NO
Have you ever had a license, certificate or registration disciplined (revoked, suspended, placed on probation or
reprimanded) or voluntarily surrendered in any state or jurisdiction?
YES NO
Do you currently engage in drug-related behavior, including the use of mood-altering drugs/substances and/or
alcohol that would affect your functional abilities to perform while working as a surgical technologist?
YES NO
In the last two years, have you been the subject of a chemical or alcohol dependency intervention or participated
in chemical or alcohol dependency treatment/rehabilitation?
YES NO
If you answered yes to any of the above questions, please give a detailed explanation to each yes answer.
_____________________________________________ ______________________________________ Applicant’s Signature Date
Your signature indicates that you have been apprised of background requirements for area healthcare facilities.
Please select one or more of the following, as applicable: *Additional Information (used for research purposes and
federal and state reporting requirements, not for admission consideration.)
American Indian or Alaskan Native Asian Black or African American Native Hawaiian or Other Pacific
Islander White Are you a veteran Yes No
Are you Hispanic or Latino Yes No Are you a citizen of the U.S. Yes No If no, country or origin
_________________________ Marital Status: Married Single Divorced Separated Widowed
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Background Screening Consent
Applicant should complete all relevant information and sign and date the form.
I,________________________________________, hereby authorize Northwest Technical Institute and/or its agents to
make an independent investigation of my background, references, character, part employment, education, credit history,
adult criminal or police records, and motor vehicle records including those maintained by both public and private
organizations and all public records for the purpose of confirming the information contained on my application and/or
obtaining other information which may be material to my qualifications for entrance into the clinical setting.
I release Northwest Technical Institute and its agent and any person or entity, which provides information pursuant to this
authorization, from any and all liabilities, claims or law suits in regards to the information obtained from any and all of
the above referenced sources used. The following is my true and complete legal name and all information is true and
correct to the best of my knowledge:
Full Name (Printed) ____________________________________________________________________
Maiden Name or Other Names Used______________________________________________________
Social Security Number: _______________________________________Date of Birth: ____/____/____
Present Address________________________________________________________________________
City___________________________________________State___________________Zip Code________
How Long at Present Address? ___________________________________________________________
Former Address________________________________________________________________________
City___________________________________________State___________________Zip Code________
How Long at Former Address? ____________________________________________________________
Please List all states and counties of residence since turning age 18:
_________________________________________________________________________________________________
_______
Driver’s License Number_________________________________________ State of License __________
Signature of Applicant __________________________________________ DATE___________
*NOTE: The above information is required for identification purposes only, and is in no manner used as qualifications
for employment, internship, or service as a volunteer. Northwest Technical Institute abides by all applicable state and
federal employment laws.
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STERILE PROCESSING TECHNICIAN APPLICATION FOR ENROLLMENT Please write a brief statement about yourself, giving your reasons for choosing Sterile Processing as a career and include
your autobiographical background:
___________________________________________________ _________________________________________
APPLICANT’S SIGNATURE DATE
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Northwest Technical Institute
Sterile Processing Technician Program Duties Acknowledgement Form Duties and Responsibilities: A SPT is a healthcare professional who is primarily responsible for everything in the workroom, sterile processing and making sure
policies and procedures are followed to ensure proper sterilization of surgical instrumentation
Cleans each item according to the manufacturers instruction
Inspects instruments under microscope for damage and defects; lubricates items as required
Determines that each item is in good working condition
Sorts and arranges items in proper trays according to established policy and procedure
Correctly operates sterilizers, ultrasonic washer and other equipment for processing items
Performs required biological monitoring test on all sterilizers according to established policy and procedure Checks for outdated items and package integrity of wrapped sterilized items; replaces items as necessary
Maintains adequate inventory of supplies for the sterile processing area
Special Qualifications: In addition to minimum requirements regarding reading, language and math skills, the student must, unassisted:
1. Demonstrate understanding of sterilization principles required
2. Constant and frequent judgement and response required
3. Using the English language skills to communicate effectively with staff
Psychomotor Qualifications: 1. Vision – Normal, corrected. Demonstrate sufficient ability to assemble like instruments together
2. Hearing – Normal corrected or aid able. Hear and understand muffled communication without visualization of the
communicator’s mouth/lips within 20 feet
3. Smell – Able to detect odors sufficient to maintain environmental safety and patient needs
4. Touch – Normal tactile sensitivity. Manipulate instruments, supplies and equipment with speed, dexterity and good eye-hand
coordination
Physical Demand: 1. While performing the duties of this job the employee is frequently required to sit, converse, and listen; use hands to touch,
handle, or feel objects, tools or controls; and to reach with hands and arms. Specific vision abilities required by this job
include close vision and the ability to adjust focus
2. The employee must be able to lift and/or carry over 20 pounds on a regular basis and be able to push/pull over 25 pounds on a
regular basic
3. The employee must be able to stand and/or walk at least 5 hours per day
Communication Qualifications: 1. The ability to interact and verbally communicate with others
2. Ability to communicate and understand fluent English, both verbally and in writing
I have read the above and feel that it is within my ability to carry out the duties, responsibilities and qualifications of a Sterile
Processing Technician (SPT). I do______ do not______ (check one) have any problems meeting the above technical requirements.
In the event that I am selected for the ST program, I understand that it will be necessary for me to demonstrate the technical
requirements during my clinical training. I understand that any misrepresentation or falsification of information is cause for denial of
admission. Upon discovery of falsification of stated ability, a student that has been admitted to the program may not be able to
continue.
_____________________________________________ _______________________________________
Signature of Applicant Date
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STERILE PROCESSING TECHNICIAN APPLICATION FOR ENROLLMENT
EMPLOYMENT HISTORY: List most recent first. If you do not have an employment history, please indicate
in the space provided below.
EMPLOYER MAILING ADDRESS JOB DATES
FROM TO
PERSONAL REFERENCES: Other than relatives
NAME/RELATIONSHIP PHONE
Employment Reference Letter: You will need two (1). Complete the top portion of each form and sign it.
Leave the signed forms with your current or previous employers. The letter is to be completed by the employer
and sent directly to NWTI. Employment reference letter submitted from the applicant will not be accepted.
One personal reference should be submitted if you do not have professional reference.
In keeping with the guidelines on Title VI, Sections 602, Civil Rights Act of 1964; Title IX, Section 901,
Education Amendments of 1972; and Section 504 of the Rehabilitation Act of 1973, this school assures that no
person in the United States shall, on the basis of race, color, national origin, sex, or handicap be excluded from
the participation in, be denied benefit of, or be subjected to discrimination under any person or activity
administered by the school.
I hereby affirm that all information supplied for this application is complete and accurate. It is my
understanding that I shall not be considered for admission until I have submitted all credentials
specified. I understand that withholding information requested or giving false information may make me
ineligible for admission and enrollment. I also understand that upon discovery of any falsified
information on this application I will be subject to immediate dismissal from the program.
___________________________________________________ _________________________________________
APPLICANT’S SIGNATURE DATE
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NORTHWEST TECHNICAL INSTITUTE
STERILE PROCESSING TEHCNINICAN
P.O. BOX 2000
SPRINGDALE, AR 72765-2000
Phone: (479) 751-8824 Ext. 116
EMPLOYMENT REFERENCE LETTER
Employment reference letters submitted to NWTI directly from the applicant will not be accepted.
Employment Reference Letter should be completed and mailed by the employer and sent directly to NWTI no later than. Employment
reference letter submitted to NWTI directly from the applicant will not be accepted!
PART I – TO BE COMPLETED BY PN APPLICANT. ONCE COMPLETED, SEND TO EMPLOYER.
Employer Name and Address, ___________________________________________
& Phone Number: ___________________________________________
___________________________________________
Applicant’s Name:
I authorize the above named employer to release to Northwest Technical Institute any information in my personnel file for the purpose
of entry into the Sterile Processing Technician Program.
______________________________________________
Applicant's Signature Date
PART II–FOR EMPLOYER. PLEASE COMPLETE AND MAIL TO NWTI.
The above person has applied for admission to our Sterile Processing Technician Program and has given your name as a reference.
Will you kindly give us your candid opinion of this applicant's suitability for the duties of a surgical technologist? All information will
be kept confidential. Thank you for your assistance.
Employment Dates: Would you rehire this applicant?
Job Responsibilities:
Evaluate the applicant on the following 1 – 5 scale:
1=Unacceptable 2=Poor 3=Fair 4=Good 5=Excellent
Ability to get along with others 1 2 3 4 5 Initiative 1 2 3 4 5
Reaction under stress 1 2 3 4 5 Responsibility 1 2 3 4 5
Character 1 2 3 4 5 Dependability 1 2 3 4 5
Honesty 1 2 3 4 5 Efficiency 1 2 3 4 5
Please give us any further information that you might have about this individual that will help us to decide upon his/her suitability for
the Sterile Processing Technician (SPT) Program.
Signature/Title Date
